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Peter Sidaway
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June 2017: Nature Reviews. Clinical Oncology
Aránzazu González Del Alba, José Ángel Arranz, Javier Puente, María José Méndez-Vidal, Enrique Gallardo, Enrique Grande, Begoña Pérez-Valderrama, Enrique González-Billalabeitia, Martín Lázaro-Quintela, Álvaro Pinto, Nuria Lainez, Josep M Piulats, Emilio Esteban, José Pablo Maroto Rey, Jorge A García, Cristina Suárez
Updated information published up to 2016 regarding major advances in renal cancer, bladder cancer, and prostate cancer is here presented. Based on an ever better understanding of the genetic and molecular alterations that govern the initial pathogenic mechanisms of tumor oncogenesis, an improvement in the characterization and treatment of urologic tumors has been achieved in the past year. According to the Cancer Genome Atlas (ATLAS) project, alterations in the MET pathway are characteristics of type 1 papillary renal cell carcinomas, and activation of NRF2-ARE pathway is associated with the biologically distinct type 2...
May 2017: Critical Reviews in Oncology/hematology
J Bellmunt, J M Kerst, F Vázquez, R Morales-Barrera, E Grande, A Medina, Mªb González Graguera, G Rubio, U Anido, O Fernández Calvo, E González-Billalabeitia, Ajm Van den Eertwegh, E Pujol, J L Perez-Gracia, J L González Larriba, R Collado, M Los, S Maciá, R De Wit
BACKGROUND: Despite the advent of immunotherapy in urothelial cancer, there is still a need to find effective cytotoxic agents beyond first and second line. Vinflunine is the only treatment approved in this setting by the European Medicines Agency (EMA) and taxanes are also widely used in second line. Cabazitaxel is a taxane with activity in docetaxel-refractory cancers. A randomized study was conducted to compare its efficacy vs vinflunine. PATIENTS AND METHODS: This is a multicenter, randomized, open-label, phase II/III study, following a Simon's optimal method with stopping rules based on an interim futility analysis and a formal efficacy analysis at the end of the phase II...
April 13, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
Jesus García-Donas, Albert Font, Begoña Pérez-Valderrama, José Antonio Virizuela, Miquel Ángel Climent, Susana Hernando-Polo, José Ángel Arranz, Maria Del Mar Llorente, Nuria Lainez, José Carlos Villa-Guzmán, Begoña Mellado, Aránzazu González Del Alba, Daniel Castellano, Enrique Gallardo, Urbano Anido, Xavier García Del Muro, Montserrat Domènech, Javier Puente, Rafael Morales-Barrera, Jose Luis Pérez-Gracia, Joaquim Bellmunt
BACKGROUND: Maintenance therapy improves outcomes in various tumour types, but cumulative toxic effects limit the choice of drugs. We investigated whether maintenance therapy with vinflunine would delay disease progression in patients with advanced urothelial carcinoma who had achieved disease control with first-line chemotherapy. METHODS: We did a randomised, controlled, open-label, phase 2 trial in 21 Spanish hospitals. Eligible patients had locally advanced, surgically unresectable, or metastatic transitional-cell carcinoma of the urothelial tract, adequate organ function, and disease control after four to six cycles of cisplatin and gemcitabine (carboplatin allowed after cycle four)...
April 4, 2017: Lancet Oncology
Joaquim Bellmunt, Ronald de Wit, David J Vaughn, Yves Fradet, Jae-Lyun Lee, Lawrence Fong, Nicholas J Vogelzang, Miguel A Climent, Daniel P Petrylak, Toni K Choueiri, Andrea Necchi, Winald Gerritsen, Howard Gurney, David I Quinn, Stéphane Culine, Cora N Sternberg, Yabing Mai, Christian H Poehlein, Rodolfo F Perini, Dean F Bajorin
BACKGROUND: Patients with advanced urothelial carcinoma that progresses after platinum-based chemotherapy have a poor prognosis and limited treatment options. METHODS: In this open-label, international, phase 3 trial, we randomly assigned 542 patients with advanced urothelial cancer that recurred or progressed after platinum-based chemotherapy to receive pembrolizumab (a highly selective, humanized monoclonal IgG4κ isotype antibody against programmed death 1 [PD-1]) at a dose of 200 mg every 3 weeks or the investigator's choice of chemotherapy with paclitaxel, docetaxel, or vinflunine...
March 16, 2017: New England Journal of Medicine
Syed A Hussain, Jawaher Ansari, Robert Huddart, Derek G Power, Jeanette Lyons, James Wylie, Maria Vilarino-Varlela, Nils O Elander, Rhona McMenemin, Lisa M Pickering, Guy Faust, Seema Chauhan, Richard J Jackson
There is no standard of care in the UK or Ireland for second-line chemotherapy for patients with advanced transitional cell carcinoma (TCCU). Vinflunine is approved for TCCU patients who have failed a platinum-based regimen, and is standard of care in Europe but is not routinely available in the UK. Data were collected retrospectively on patients who received vinfluine as a second-line treatment. The aims were to document the toxicity and efficacy in a real life setting. Data were collected on 49 patients from 9 sites across the UK and Ireland [median age, 64 (IQR, 57-70) years, 33 males]...
March 2017: International Journal of Oncology
Holger Gerullis, Friedhelm Wawroschek, Claus-Henning Köhne, Thorsten Holger Ecke
Vinflunine (VFL) has been approved in Europe for second-line treatment of metastatic and advanced urothelial cancer after failure of platin-containing therapy. Since approval, the drug has been investigated in few clinical trials. Most of the currently available reports describe experiences with VFL in a daily clinical setting. This review gives a short overview on clinical experiences and clinical trials involving VFL since the approval of this drug in 2009.
January 2017: Therapeutic Advances in Urology
M Lázaro, E Gallardo, M Doménech, Á Pinto, A González Del Alba, J Puente, O Fernández, A Font, N Lainez, S Vázquez
The goal of this article is to provide recommendations for the diagnosis and treatment of muscle-invasive and metastatic bladder cancer. The diagnosis of muscle-invasive bladder cancer is made by pathologic evaluation after transurethral resection. Recently, a molecular classification has been proposed. Staging of muscle-invasive bladder cancer must be done by computed tomography scans of the chest, abdomen and pelvis and classified on the basis of UICC system. Radical cystectomy and lymph node dissection are the treatment of choice...
December 2016: Clinical & Translational Oncology
M Rouprêt, Y Neuzillet, A Masson-Lecomte, P Colin, E Compérat, F Dubosq, N Houédé, S Larré, G Pignot, P Puech, M Roumiguié, E Xylinas, A Méjean
OBJECTIVE: The purpose of the guidelines national committee CCAFU on bladder cancer was to propose updated french guidelines for non-muscle invasive (NMIBC) and invasive (MIBC) bladder cancers. METHODS: A Medline search was achieved between 2013 and 2016, as regards diagnosis, options of treatment and follow-up of bladder cancer, to evaluate different references with levels of evidence. RESULTS: Diagnosis of NMIBC (Ta, T1, CIS) is based on a complete deep resection of the tumour...
November 2016: Progrès en Urologie
Jorge García, Lucia Santomé, Urbano Anido, Ovidio Fernández-Calvo, Javier Afonso-Afonso, Martín Lázaro, Ana Medina, Sergio Vázquez Estévez
Once metastatic bladder cancer has progressed to first-line treatment, the number of therapeutic options is scarce. Among chemotherapeutic agents showing activity in phase II trials, including taxanes, vinflunine (VFL) is the only one shown to increase overall survival in a phase III trial. In addition to its efficacy, VFL is safe in special population groups. Despite this, the prognosis for these patients remains poor, and more effective therapies need to be developed. Agents acting on new therapeutic targets as well as biomarkers to aid matching patients to specific treatments are currently under evaluation...
December 2016: Current Oncology Reports
C Genova, A Alama, S Coco, E Rijavec, M G Dal Bello, I Vanni, F Biello, G Barletta, G Rossi, F Grossi
Vinflunine belongs to the class of vinca alkaloids and acts by disrupting the microtubule dynamics during cell cycle; this agent is currently available for previously treated advanced transitional cell carcinoma in Europe. The aim of this invited review is to evaluate the potential role of vinflunine for the treatment of non-small cell lung cancer (NSCLC). Areas covered: The potential role of vinflunine in NSCLC is discussed on the basis of the available data, including full papers and meeting abstracts. Relevant preclinical studies describing the pharmacological properties of vinflunine are also included...
December 2016: Expert Opinion on Investigational Drugs
N Houédé, G Locker, C Lucas, H Soto Parra, U Basso, D Spaeth, R Tambaro, L Basterretxea, F Morelli, C Theodore, L Lusuardi, N Lainez, A Guillot, G Tonini, J Bielle, X Garcia Del Muro
BACKGROUND: Platinum-based systemic chemotherapy is considered the backbone for management of advanced urothelial carcinomas. However there is a lack of real world data on the use of such chemotherapy regimens, on patient profiles and on management after treatment failure. METHODS: Fifty-one randomly selected physicians from 4 European countries registered 218 consecutive patients in progression or relapse following a first platinum-based chemotherapy. Patient characteristics, tumor history and treatment regimens, as well as the considerations of physicians on the management of urothelial carcinoma were recorded...
September 23, 2016: BMC Cancer
Paola Bordi, Marcello Tiseo, Giorgio Baldari, Sebastiano Buti
BACKGROUND: Patients undergone kidney transplantation present higher risk of Urothelial Carcinoma (UC) development and represent a subgroup of special interest. To date, vinflunine is the only drug approved in Europe for the treatment of advanced UC after failure of platinum-based chemotherapy. However, to our knowledge, no data on the concomitant administration of vinflunine and immunosuppressive agents are available. CASE PRESENTATION: The patient, a 45 years old Caucasian male, presented poorly differentiated UC of the bladder recurred after initial cystectomy with abdominal lymphadenopathies evidenced by FDG-PET/CT...
2016: BMC Cancer
Carole Gourmelon, Héloïse Bourien, Paule Augereau, Anne Patsouris, Jean-Sébastien Frenel, Mario Campone
INTRODUCTION: Breast cancer is the most frequently diagnosed cancer and the highest cause of cancer mortality in females worldwide. The development of drugs improving overall survival in late-stage metastatic breast cancer remains a challenge. Vinflunine is the most recently developed drug in the vinca alkaloid class. Its arrival has been eagerly awaited for treatment of solid tumors, and in particular, for metastatic breast cancer. AREAS COVERED: The pharmacological features of vinflunine are described...
September 2016: Expert Opinion on Pharmacotherapy
Karin Holmsten, Line Dohn, Niels Viggo Jensen, Carl-Henrik Shah, Fredrik Jäderling, Helle Pappot, Anders Ullén
In 2009, vinflunine was introduced as a second-line treatment to be used after the failure of platinum therapy in patients with metastatic urothelial carcinoma (mUC). The present study investigated the administered vinflunine to patients with mUC in standard clinical practice with the aim of evaluating treatment patterns, response, survival parameters and side-effects. Data were collected retrospectively from the first 100 mUC patients treated with vinflunine at three Nordic cancer centers associated with the Nordic Urothelial Cancer Oncology Group...
August 2016: Oncology Letters
Jeanny B Aragon-Ching, Donald L Trump
Bladder urothelial cancers remain an important urologic cancer with limited treatment options in the locally advanced and metastatic setting. While neoadjuvant chemotherapy for locally advanced muscle-invasive cancers has shown overall survival benefit, clinical uptake in practice have lagged behind. Controversies surrounding adjuvant chemotherapy use are also ongoing. Systemic therapies for metastatic bladder cancer have largely used platinum-based therapies without effective standard second-line therapy options for those who fail, although vinflunine is approved in Europe as a second-line therapy based on a Phase III trial, and most recently, atezolizumab, a checkpoint inhibitor, was approved by the US FDA...
September 2016: Future Oncology
G Sonpavde, G R Pond, G Di Lorenzo, C Buonerba, A Rozzi, G Lanzetta, A Necchi, P Giannatempo, D Raggi, K Matsumoto, T K Choueiri, S Mullane, G Niegisch, P Albers, J L Lee, H Kitamura, H Kume, J Bellmunt
BACKGROUND: Trials of salvage therapy for advanced urothelial carcinoma have required prior platinum-based therapy. This practice requires scrutiny because non-platinum-based first-line therapy may be offered to cisplatin-ineligible patients. PATIENTS AND METHODS: Data of patients receiving salvage systemic chemotherapy were collected. Data on prior first-line platinum exposure were required in addition to treatment-free interval, hemoglobin, Eastern Cooperative Oncology Group performance status, albumin, and liver metastasis status...
May 12, 2016: Clinical Genitourinary Cancer
Gaetano Facchini, Chiara Della Pepa, Carla Cavaliere, Sabrina C Cecere, Marilena Di Napoli, Carmine D'Aniello, Anna Crispo, Gelsomina Iovane, Piera Maiolino, Teresa Tramontano, Raffaele Piscitelli, Salvatore Pisconti, Maurizio Montella, Massimiliano Berretta, Domenico Sorrentino, Sisto Perdonà, Sandro Pignata
BACKGROUND: The efficacy of Vinflunine, after failure of platinum-based chemotherapy in patients with metastatic or recurrent Transitional Cell Cancer of the Urothelial Tract, TCCU, has been demonstrated in an international, randomized, phase III trial comparing Vinflunine plus Best Supportive Care, BSC, with BSC alone. On the basis of that study vinflunine has been approved by the European Medicine Association, EMA, for treatment of TCCU patients after failure of a platinum treatment...
2016: Frontiers in Pharmacology
Jacques Médioni, Mario Di Palma, Aline Guillot, Dominique Spaeth, Christine Théodore
BACKGROUND: To retrospectively assess the efficacy and safety of Vinflunine (VFL) under routine conditions and identify overall survival (OS) prognostic factors. METHODS: Twenty centres participated in the retrospective study (minimum 4 patients undergoing VFL treatment for advanced/metastatic UC after platinum-based regimen progression. Primary endpoint was OS. Secondary endpoints: progression-free survival (PFS), radiological response rate (RR) RECIST criteria and toxicity (CTC NCI v3)...
March 14, 2016: BMC Cancer
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